P391 The availability of anti-TNF agents is associated with reduced early surgical requirements in Crohn’s disease but not in ulcerative colitis. A nationwide study from the Eneida registry

Guasch, Montserrat; Clos, Ariadna; Ordás, Íngrid; García–Sánchez, Valle; Gisbert, Javier P.; Taxonera, Carlos; Vera, Isabel; Mínguez, Miguel; Guardiola, Jordi; López-Sanromán, Antonio; Rivero-Tirado, M.; Nos, Pilar; Gomollón, Fernando; Carbajo, Ana Yaiza; Francisco, Ruth de; Martín-Arranz, María Dolores; García‐Planella, Esther; García-López, Santiago; Castro, Luísa; Calvet, Xavier; Camargo, Raquel; Esteve, María; Sicilia, B; Andreu, M.; Macho, A; Piqueras, Marta; Bermejo, Fernando; Gutiérrez, Ana; Busquets, David; Martínez-Montiel, Pilar; Hinojosa, Joaquín; Pérez-Calle, J L; Bujanda, Luís; Rodríguez-Pérez, Antonio; Lorente, Rufo; Jiménez, Nuria; Navarro-Llavat, M; Cabriada, José Luis; Camo, Patricia; Domselaar, Manuel Van; Rodríguez-González, ez Mauricio; Rodríguez-Gutiérrez, Cristina; Huguet, J M; Lucendo, Alfredo J.; Argüelles, F; Almela, Pedro; Merino, Olga; Calafat, Margalida; Ogueta, M Á; Charro, Mara; Llaó, Jordina; Muñoz, Concepción; Ramos, Laura; Abad, Águeda; Roncero, Óscar; Barreiro-de-Acosta, Manuel; Sesé, E; Mañosa, Míriam; Domènech, Eugeni

doi:10.1093/ecco-jcc/jjx180.518

Cited by 3 publications

(6 citation statements)

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“…A total 5138 unique studies were identified using our search strategy. Of these, 137 full-text articles were reviewed, and 44 studies were included in quantitative synthesis, reporting on 26 cohorts of patients with UC, 11, 22 cohorts of patients with CD, 9,11,17,21,23,27,[30][31][32]39,[41][42][43][44][45][46][47][48][49][50][51][52] and 8 cohorts of patients with CD with prior surgery. 9,10,45,[53][54][55][56][57] Ninety-three studies were excluded, with detailed reasons reported in Supplementary Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Table 2 details the characteristics of 22 studies in patients with CD reporting on risk of first surgery. 9,11,17,21,23,27,[30][31][32]39,[41][42][43][44][45][46][47][48][49][50][51][52] These studies included patients diagnosed between 1955 and 2015, with sample sizes ranging from 53 to 13,185 patients with CD; a large study was a Danish nationwide register-based study. 11 Two studies were conducted exclusively on pediatriconset CD.…”

Section: Cumulative Risk Of First Major Abdominal Surgery In Patients...mentioning

confidence: 99%

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Contemporary Risk of Surgery in Patients With Ulcerative Colitis and Crohn’s Disease: A Meta-Analysis of Population-Based Cohorts

Tsai

Dulai

et al. 2021

Clinical Gastroenterology and Hepatology

180

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Section: Resultsmentioning

confidence: 99%

Section: Cumulative Risk Of First Major Abdominal Surgery In Patients...mentioning

confidence: 99%

Contemporary Risk of Surgery in Patients With Ulcerative Colitis and Crohn’s Disease: A Meta-Analysis of Population-Based Cohorts

Tsai

Dulai

et al. 2021

Clinical Gastroenterology and Hepatology

180

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“…En similitud a nuestra serie, 53% de pacientes con EC y 7% con CU recibieron cirugía en el periodo de estudio. En contraste, publicaciones recientes indican que la tasa de cirugía en EII se ha mantenido estable (21,22) . En nuestra serie, la mediana de edad fue de 45 años para EC y 57 años para CU.…”

Section: Discussionunclassified

“…La enfermedad inflamatoria intestinal (EII), un trastorno inflamatorio crónico del intestino, tiene como principales representantes a la colitis ulcerativa (CU) y enfermedad de Crohn (EC) (1)(2)(3) . En la CU, la inflamación es continua, restringida a la mucosa, afecta principalmente el recto, aunque puede extenderse a todo el colon.…”

Section: Introductionunclassified

Manejo médico quirúrgico de la enfermedad inflamatoria intestinal moderada-severa

Méndez

Pérez

Marcacuzco

et al. 2021

Rev Gastroenterol Peru

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El tratamiento de la enfermedad inflamatoria intestinal (EII) es principalmente médico, sin embargo, más del 70% de pacientes con enfermedad de Crohn (EC) y 25% con colitis ulcerativa (CU) requerirán cirugía. Objetivos: Evaluar el manejo médico- quirúrgico y evolución en pacientes con EII moderada-severa. Materiales y métodos: Estudio observacional, descriptivo, retrospectivo de enero del 2011 a diciembre del 2019 en el Servicio de Gastroenterología del Hospital Nacional Guillermo Almenara Irigoyen, Lima-Perú. Resultados: Se incluyó 22 pacientes con EII, 17 con EC y 5 con CU. El 59% fueron masculinos. Se realizó cirugía de emergencia en el 35,2% y el 60% de los pacientes con EC y CU respectivamente. La estenosis y el megacolon tóxico fueron las indicaciones más frecuentes. Según el tipo de cirugía, la hemicolectomía (41%) y la resección intestinal (41%) fueron las más frecuentemente realizadas en EC, mientras que, en CU fue la colectomía total (60%). Dentro de las complicaciones postquirúrgicas, las dehiscencias/fistulas y colecciones intraabdominales fueron las más frecuentemente reportadas en EC; mientras que, en CU fue la infección del sitio operatorio e íleo adinámico. Luego de cirugía, los biológicos y los 5-ASA asociados a inmunomodulador fueron el tratamiento más utilizados en EC y CU respectivamente. La mortalidad fue del 17,6% en EC y 60% en CU. Conclusiones: El tratamiento quirúrgico es una op la EII moderada-severa. La cirugía de emergencia en EII continúa presentando una alta morbimortalidad.

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“…Most surgery rate data are from patients treated with an anti-TNFα treatment [ 13 – 16 ], which have been available for more than two decades [ 6 ]. The newer biologics ustekinumab and vedolizumab have demonstrated efficacy over placebo for the induction and maintenance of remission [ 17 – 19 ], but little is known about their impact on surgery rates.…”

Section: Introductionmentioning

confidence: 99%

Comparison of surgery rates in biologic-naïve patients with Crohn’s disease treated with vedolizumab or ustekinumab: findings from SOJOURN

Ghosh

Umashankar

et al. 2023

BMC Gastroenterol

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Background Crohn’s disease (CD) is a chronic inflammatory bowel disease characterized by relapsing and remitting inflammation that leads to progressive bowel damage. Despite advances in medical treatment for CD, many patients require surgical intervention. Most studies of surgery rates are from patients treated with anti-tumor necrosis factor alpha (anti-TNFα) treatments, with comparatively little data on the surgery rates of patients treated with vedolizumab and ustekinumab. SOJOURN aimed to estimate the hazard rate and incidence of the first CD-related surgery following initiation of treatment with vedolizumab or ustekinumab in biologic-naïve patients with CD. Methods SOJOURN was a retrospective, observational cohort study examining administrative claims data from the Optum® Research Database between July 1, 2017 and March 31, 2020. Included participants were adults with a diagnosis of CD and a claim for vedolizumab or ustekinumab (defined as the index treatment) between January 1, 2018 and December 31, 2019, with no claims for a biologic in the 6 months before initiation of this treatment. The variable follow-up started on the day after the index date and continued until whichever came first of discontinuation of the index treatment, surgery event, switching of the index treatment, initiation of combination biologic treatment, disenrollment, or March 31, 2020. The time to the first CD-related surgery on biologic treatment was estimated by Kaplan–Meier analysis. The hazard ratio and incidence rate ratio of CD-related surgery for each treatment cohort was compared using a Cox proportional hazards model and a Poisson regression model, respectively. Results Of the 1,122 included patients, 578 received vedolizumab and 544 received ustekinumab. After 1 year of the variable follow-up, 7.7% of patients receiving vedolizumab and 11.6% of patients receiving ustekinumab had undergone a CD-related surgery. Vedolizumab was associated with a 34.2% lower hazard rate of surgery (hazard ratio 0.658, 95% confidence interval [CI] 0.436–0.994, p = 0.047) and a 34.5% lower incidence of surgery (rate ratio 0.655, 95% CI 0.434–0.988, p = 0.044) than ustekinumab. Conclusions This real-world analysis of biologic-naïve patients with CD suggests that vedolizumab is associated with greater effectiveness in reducing the rate of CD-related surgery than ustekinumab.

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P391 The availability of anti-TNF agents is associated with reduced early surgical requirements in Crohn’s disease but not in ulcerative colitis. A nationwide study from the Eneida registry

Cited by 3 publications

References 0 publications

Contemporary Risk of Surgery in Patients With Ulcerative Colitis and Crohn’s Disease: A Meta-Analysis of Population-Based Cohorts

Contemporary Risk of Surgery in Patients With Ulcerative Colitis and Crohn’s Disease: A Meta-Analysis of Population-Based Cohorts

Manejo médico quirúrgico de la enfermedad inflamatoria intestinal moderada-severa

Comparison of surgery rates in biologic-naïve patients with Crohn’s disease treated with vedolizumab or ustekinumab: findings from SOJOURN

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